Great Western Hospital

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that people were always treated with kindness, empathy and compassion. We checked that people's privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people's wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always caring. The service was in breach of the legal regulations relating to relation to dignity and respect.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff tried to maintain privacy and dignity for patients by closing cubicle doors and drawing privacy curtains. In addition to this we observed staff lowering the tone and volume of their voice in order to maintain privacy.

However, patients’ privacy and dignity was not always maintained. Patients were regularly being cared for in the corridors for long periods of time due to lack of available beds. We saw a young patient in the corridor next to majors who was not fully covered up, which meant she was exposed in an open environment where staff received handover from ambulance staff. We didn’t see screens being used when patients were being cared for.

We reviewed the results for the friends and family test for the emergency department and the urgent treatment centre between from October 2024 to March 2025. Positive themes which emerged included staff attitude, waiting time and implementation of care. Negative themes included waiting time, environment and staff attitude.

Patient comments from the friends and family results read ‘Staff were all so kind and compassionate towards me and I really appreciated that during what was a difficult time for me.’ Another read, ‘Thank you all for the way you treated me, you were all so friendly, reassuring and efficient’.

Throughout the inspection, we observed staff displaying a caring attitude towards patients and treating them with kindness. Patients we spoke with said staff were very caring, helpful and pleasant.

Staff interacted kindly with patients throughout the department including whilst they were being cared for in the corridor.

We observed staff interacting with children in a kind way and explained things to them in a child friendly way. Staff wore ID badges and introduced themselves.

The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. Staff took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. Staff took account of people’s abilities, aspirations, culture and unique backgrounds and protected characteristics.

We observed staff speaking and explaining things to children in a child friendly way. We also observed staff interacting exceptionally sensitively to a young patient whilst explaining what they were going to do.

Staff talked to patients in a way they could understand, using communication aids where necessary. There were interpreting services available when required.

Staff held regular and effective multidisciplinary meetings to discuss patients and highlighted issues and outstanding tasks.

The service did not always inform people about their care and treatment so people did not always know what was happening.

However, people were supported to maintain relationships which were important to them. For example, we observed family and friends who were allowed to be with the patient when receiving care.

While some patients said they were fully informed about their care and treatment, this wasn’t the case for all the patients. We spoke with 15 patients in the department and waiting room. Four out of 15 patients told us their treatment hadn’t been explained to them. A patient told us ‘I am still sat here, and nobody has told me anything.’ Another patient told us, ‘It concerns me that they have done all sorts but not explained why they are doing it.’

Patients had access to drinking water in the waiting room and the department employed volunteers who offered teas and snacks to patients and families. Staff told us volunteers worked closely with them and helped guide patients to the right area for ongoing care.

The hospital had an onsite chaplaincy and patients and families had access to quiet spaces should they need this.

The service did not always meet people's immediate needs or respond to patients who were in distress.

Staff did not always support patients or their families who became distressed in an open environment. We saw a patient who was shouting in distress. Staff who were walking around did not attend to the patient or provide any reassurance to the patient and the daughter.

Peoples immediate needs were not always met in ambulatory majors due to increasing demand and acuity, which resulted in increased risk to patients due to delays. Whilst we did not see evidence of this, there was a potential risk of patients not receiving a timely triage, delays in time-critical interventions, administration of medicines and/or treatments and delayed discharges or ward transfers to meet their immediate needs. For example, we reviewed a complaint from a member of public who had complained about her husband who was left in the corridor for 3 hours and then back on the ambulance for a further 3 hours and then back on the corridor for another hour before being taken to majors and released. Post inspection, the trust told us that although this complaint was far from an ideal patient experience, all department process and procedures were followed to ensure management of the patient.

Staff understood and respected the individual needs of each patient and showed understanding and a non-judgmental attitude when caring for or discussing patients with mental health needs. For example, a patient presenting with a mental health condition walked out of the department against medical advice. While security staff were trying to persuade the patient to return, their physical health suddenly deteriorated. We saw staff attending to them instantly and the patient was assessed by a full clinical team which led to them recovering quickly.

We observed staff responding to people's needs quickly without delay and call bells were answered swiftly within a minute or 2 and there was a nurse who had oversight of patients in the corridor.

Patients we spoke with told us that staff asked if they were in pain and offered pain relief. A patient told us that staff had attended to her instantly and offered pain relief when she had complained about her arm being uncomfortable.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff told us they received supervision, and clinical incident reviews and debriefs following a difficult event.

Staff had access to the employee assistance program which provided support 24 hours, 7 days a week. The hospital also provided staff with clinical psychology and counselling sessions through their occupational health program.

Staff felt supported, respected and valued by their managers in all areas we visited. Supervision was seen as supportive and managers approachable. We saw that staff were encouraged to speak up.

The department carried out staff surveys and we reviewed this for the department for 2024. Results from these showed that 50% of staff agreed that the organisation took positive action on health and well-being which was worse than the organisation average of 60%.